Mike Gapes: I wish every hon. Member, all the staff and all those who provide us with our security and food in the House a very happy Christmas and restful new year.
	I also felt that my constituents would have a happy Christmas—I attended a celebration last Thursday evening of a Eid, Hanukka, Diwali and Christmas joint event in the integrationist-minded Muslim community centre at Eton road in my constituency—but on Friday morning, I attended a meeting, also in my constituency, with the local health bosses of the four primary care trusts, two acute hospital trusts and mental health trusts and representatives of the London region of the NHS to discuss a programme called "fit for the future". That was referred to in passing during last night's Adjournment debate on the fantastic new Queen's hospital in Romford, which is a great tribute to the record investment, which has increased from 7 to 9 per cent. of gross domestic product under this Labour Government. But plans are now afoot that will make health and hospital provision in my constituency seriously worse for many of the poorest people if the plans that are envisaged for the "fit for the future" team are not stopped.
	I want to spend some time dealing with that issue because I am very conscious that people all over the country raise their concerns about changes in the health service, but I am doing so in a context where we do not have static population in east London and we do not have changes in technology that can be used alone to justify changes in provision. A massive increase in population could take place just when significant reductions in hospital provision are planned in my constituency and across Ilford.
	The four PCTs in outer north-east London—Barking and Dagenham, Havering, Redbridge and Waltham Forest, each of which is borough-based—plus the Barking, Havering and Redbridge acute hospital trust, which has two hospitals, the new Queen's hospital in Romford, which has taken over the work of the old Oldchurch and Harold Wood hospitals, which have been closed, and the King George hospital in Ilford, which was a new hospital, built and opened in 1993 in my constituency to replace an old 1920s facility, plus the Whips Cross university hospital, which is based in Leytonstone and is principally a collection of 1920s and '30s buildings, and the North East London mental health trust, which covers the whole of those east London boroughs, are discussing in detail those proposals.
	Those involved have come up with five options. Given what I was told on Friday, it is clear that they favour what they call option 4, under which the accident and emergency department at King George hospital, Ilford, and the children's accident and emergency department will be closed and all elective work in the hospital will be ended. Although a new independent sector treatment centre is just about to open, it has a five-year contract for a minimum number of operations. It will be there for five years, but not necessarily for much longer.
	Over recent months, we have had a series of what the local NHS bosses call stakeholder workshops, run by a firm of management consultants called Finnamore. They have taken the circumstances of a few dozen local people supposedly to model various options with various weightings, which are then supposed to give an objective outcome of choice. They have had problems with their process. They were supposed to make the proposals public by the end of the year. They now intend to put them to the boards of the four PCTs in January. If they are approved, they will then go to the London NHS in February. A public consultation exercise to rubber-stamp the process will then be run for three months, presumably from March until the end of June or July.
	But in my opinion, on the information that I have, that whole exercise is rigged, flawed and unacceptable. Why do I say that it is rigged? I do so because London NHS is not asking every area in London to undertake similar exercises; only our areas in London are doing so, and none of the neighbouring boroughs, Newham and Hackney, nor the areas of Essex—where, for example, Harlow hospital is located—is undertaking a similar exercise. The exercise is constructed simply to look at patient flows and the local health economy of outer north-east London.
	What is very interesting is that those involved have come up with proposals that are designed to reduce the services in some hospitals in my area, while no consideration is given to the neighbouring boroughs. We have discovered that there is, in effect, a preconceived agenda: as the new hospital is built up and established at Romford, it is a fixed point, and they are trying to create a situation where either the Whipps Cross hospital in Leytonstone or the King George hospital in Ilford is significantly downgraded.
	The whole basis of the process is designed, of course, to create rivalry between neighbouring Members of Parliament and neighbouring communities. In those circumstances, it is very difficult to take an objective look at the overall situation. Those involved are failing to take account of the facts. I got these figures from the Library last week, and the facts are that the population of my borough, Redbridge, based on natural factors—fertility, demographics and the movement of people in, not additional house building—will increase over the next 25 years, from 2004 to 2029, by a total of 46,300. Havering's population will go up by 14,700, and Barking and Dagenham's by 12,000. Yet there is no provision for any new hospital facilities; on the contrary, there is a reduction.
	At the same time, let us take account of the proposed house building. My hon. Friend the Member for Thurrock (Andrew Mackinlay) referred to the Thames Gateway. At present, 1.5 million people live in the whole of that area, from east London to the south of Essex and north Kent on the other side of the Thames. Over the next 10 years, until 2016, something like 128,500 new homes are going to be built in that area. In just 10 years, the population is going to increase by15 per cent. That will mean 275,000 additional people in the Thames Gateway area. A large proportion of that increase is in the Thames Gateway area of the east London boroughs and alongside the Essex part of the River Thames.
	In 2004, before the North East London strategic health authority was abolished and merged into the new London NHS, it said that, in the 10 years, there would be increases in population of 100,000 or 51 per cent. in Tower Hamlets; 99,000 or 40 per cent. in Newham; 7,000 or 3 per cent. in Havering; 17,000 or 8 per cent. in Waltham Forest—although that is outside the Thames Gateway area—and 21,000 or 9 per cent. in Redbridge. Most significantly, it said that in Barking and Dagenham, which is where people go from to King George hospital in Ilford, there will be 44,000 additional people—a27 per cent. increase in the population—in the next10 years.
	There are no plans to build any new hospitals in the Thames Gateway whatsoever. From the Newham general hospital and the Royal London hospital right the way through to Basildon there are no new hospitals. Yes, there is the fantastic new state-of-the-art Queen's hospital in Romford. However, it is proposed to take out of the equation several hundred beds from either the King George hospital in Ilford, or the Whipps Cross university hospital in Leytonstone. The way that decision is pointing is that the beds will be taken out of the hospital in Ilford, in my constituency. That is being done because it is argued that there are financial deficits, which is true. The Barking, Havering and Redbridge Hospitals NHS Trust has a 4.8 per cent. deficit of £16 million on a turnover of more than£334 million. The neighbouring Whipps Cross university hospital has a deficit of £15.8 million on a turnover of £182 million, which is 8.7 per cent.—one of the largest in the country.
	I am concerned, however, that if facilities in my constituency are closed, there is no guarantee that there will be improved primary care facilities that will be proportionate to the closures that will be announced. The ongoing deficit at Whipps Cross will have to be financed. In answer to questions at the meeting on Friday, it was admitted that that deficit would take at least five years to eliminate. The Waltham Forest primary care trust has a deficit of £1.884 million to cover as well. We are facing a situation in which there is disinvestment in some services in Waltham Forest and disinvestment by Waltham Forest council in some of its social services spending. We in Ilford will presumably make a contribution in the form of the savings that the primary care trust will make overall by reducing services in Ilford.
	I am conscious of time. I do not wish to go on too long, but I want to make an even more serious point. There is something bizarre about the process. On11 December, the chief executive of the NHS London region, Ruth Carnell, sent a letter to all London Members of Parliament in which she said that the NHS London region is commissioning a major document from Professor Sir Ara Dazi setting out a framework for
	"radical thinking about how to deliver services"
	across London. That is to be published in spring 2007 and a final health strategy for London will be published in the summer. That seems bizarre and absurd: one starts the process to carry out cuts in services in one part of London and then one decides the strategy for the whole of London. It is bonkers. That is the wrong way round. I cannot understand why the NHS does not say, "In view of the decision to set up this work by Professor Ara Dazi, we need to look at London as a whole and then look at the sub-parts of London—the particular boroughs, outer London north-east, south-east London and west London," rather than doing things this crazy way round. There is something seriously wrong with the way in which the matter is being approached.
	The other thing that worries me is that the local "fit for the future" team seem to have given only cursory consideration to the impact of the changes that they are making on the neighbouring areas. I have already referred to Newham and Hackney, but there is also the possibility of movement of some patients to other hospitals in London, such as the North Middlesex university hospital. We were told at the meeting on Friday, which was attended by five Members of Parliament, that those involved had written in October to ask for information from those neighbouring hospitals, but the people had not got any detailed information to give us. It does not seem that there is any sense of co-ordination, particularly given the massive increases in population that are going to take place in Newham and Tower Hamlets as a result of development in the Thames Gateway.
	Those involved have also done an odd exercise with regard to consideration of travelling to hospitals. I asked, "Have you done detailed studies of how a woman with four young children and a pram, who does not have access to a car, will get to the hospital in Romford or Whipps Cross university hospital from the south of Ilford or even from Barking and Dagenham?" I was told, "Well, we've done some simulation exercises of journey times." However, the information is not public and I suspect that, as with everything else in this case, there is a preconceived outcome and a rigged process.
	I asked the Library of the Commons for some data on travel times and the number of households that do not have access to a car. Interestingly, the wards in my constituency furthest from the hospitals are the ones with a higher number of people who do not have cars. It is odd, because the document produced by the "fit for the future" team says that "fit for the future" is supposed to be "addressing local health inequalities". Yes, it is true: it does address local health inequalities—it addresses them and makes them worse. Some 38 per cent. of households in Loxford in my constituency do not have access to a car. In Valentines the figure is also 38 per cent. and in Clementswood it is 35 per cent. The figures are slightly higher in the wards in the neighbouring borough of Barking and Dagenham. However, in leafy Monkhams, in the constituency of the right hon. Member for Chingford and Woodford Green (Mr. Duncan Smith), which is up near Whipps Cross university hospital, only 16 per cent. of households do not have access to a car.
	If services at King George hospital are run down and decimated to make it available for ambulatory care—as it is called—only, people may well have to amble there, travelling several miles, and then find that they have a more serious ailment and be rushed by ambulance to another hospital several miles away. It is a ridiculous situation. We need to stop the process. Either the London NHS should stop the whole process now or the boards of the primary care trusts—particularly Redbridge—should vote down the proposals so that they cannot go through and are referred back. Alternatively, if we go through this exercise, I hope that tens of thousands of local people throughout Redbridge, Barking, Dagenham and elsewhere will come out and say loudly, "No, we do not want King George hospital to be closed." If that does not work, Redbridge council's scrutiny committee should refer the matter to the Secretary of State so that we can deal with this nonsense.
	I believe passionately that the Government have done a lot of good things to improve investment in the NHS, but we have a set of self-serving, bureaucratic, accountant-minded managers who are coming up with proposals that are not in the interests of the poorest people in the poorest communities, including those in my constituency. These mad proposals have to be stopped.